tbuckley/cabot-search huggingface dataset:
AB0003 INTERLEUKIN 17A RS2275913 GENE POLYMORPHISM IS RELATED TO SEVERITY AND DISEASE ACTIVITY OF RHEUMATOID ARTHRITIS AND INCREASED SERUM IL17A LEVELS IN EGYPTIAN PATIENTS.
Authors: M. E. Ibrahim, S. A. Fattah, M. Abdelfattah, E. Mehanna
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Interleukin 17A (IL17A), one of the IL-17 family, performs a critical role in the inflamed synovial tissue of Rheumatoid Arthritis (RA) patients. Several studies have been performed to investigate the role of IL 17A rs2275913 polymorphism in RA pathogenesis, however, data about its role in RA severity and activity is inconsistent. <h3>Objectives</h3> We aimed to investigate the influence of IL17A rs2275913 polymorphism on IL17A serum levels in Egyptian RA patients and disease severity and activity. <h3>Methods</h3> The study included 100 healthy subjects and 100 RA patients. Gene polymorphism rs2275913 was measured by Taqman genotyping assay in both patients and healthy control groups. IL17A serum levels and clinical and laboratory parameters were measured using the enzyme-linked immune sorbent assay (ELISA) technique. <h3>Results</h3> RA patients showed higher IL 17A serum levels than the control group (121.9 ± 24.3 ng/dl vs 20.4 ± 2.6 ng/dl, P &lt; 0.001). RA patients showed a higher frequency of rs2275913 G allele than healthy subjects (P = 0.01). Patients carrying GG genotype showed higher values of all disease severity parameters including Rheumatoid Factor (52.79 ± 16.65 IU/ml, P&lt;0.001) and Anti-Cyclic Citrullinated Peptide Antibody (36.6 ± 14.86 U/ml, P &lt; 0.001). The high-risk GG genotype carriers had higher IL17A serum levels than the GA and AA genotypes carriers (129.74 ± 23.03 ng/dl vs 107.49 ± 19.85 ng/dl, P &lt;0.001). <h3>Conclusion</h3> The major allele of IL17A rs2275913 polymorphism was associated with higher IL17A serum levels, and greater RA severity. It is thus very likely that the rs2275913 polymorphism of IL17A gene is associated with an increased risk of RA, as well as with higher severity in Egyptian RA patients. <h3>References</h3> [1]Taams, L. S. (2020). Interleukin-17 in rheumatoid arthritis: Trials and tribulations. <i>Journal of Experimental Medicine</i>, <i>217</i>(3). [2]Shao, M., Xu, W., Yang, H., Chen, Y., Gao, X., Xu, S.,... &amp; Pan, F. (2021). Interleukin-17 Gene Polymorphism (Rs2275913 G/A, Rs763780 C/T) in Rheumatoid arthritis: Meta-analysis Based on Ethnicity. <i>Immunological Investigations</i>, <i>50</i>(6), 685-699. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1589-HPR HIGH DISEASE ACTIVITY HAS A NEGATIVE EFFECT ON PAIN CATASTROPHIZING, FEAR AVOIDANCE AND BODY AWARENESS LEVELS IN PATIENTS WITH ANKYLOSING SPONDYLITIS- A PRELIMINARY STUDY
Authors: N. B. Karaca, G. I. Kinikli, S. Sezer, B. Keleşoğlu, G. Kinikli
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankylosing spondylitis (AS) is a rheumatic disease that affects patients in a biopsychosocial framework due to its chronic inflammatory nature. It is known that patients with AS experience negative body judgment and insecurity and anxiety about their bodies [1], high levels of fear of movement, depression [2], low level of physical activity [3]. <h3>Objectives</h3> The aim of this study was to investigate the effects of disease activity (DA) on depression, physical activity, pain catastrophizing, fear avoidance, and body awareness in patients with ankylosing spondylitis. <h3>Methods</h3> Thirty AS patients were included in the study. Socio-demographic informations of patients were collected. The mean age of the patients was 40.27 ± 10.38 years. Beck Depression Inventory (BDI), International Physical Activity Questionnaire-Short Form (IPAQ-SF), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), and Body Awareness Questionnaire (BAQ) were used for depression, physical activity, pain catastrophizing, kinesiophobia and body awareness levels of the patients, respectively. DA was measured with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and a score of four and higher than four was considered active. <h3>Results</h3> Patients characteristics were similar between the groups (p&gt;0.05). A statistically significant difference was observed in PCS (p= 0.004), TSK (p=0.007), and BAQ scores (p=0.015) when the groups were compared (Table 1). The patients in the low DA group had mild depression, and the group with high DA had moderate depression. Catastrophizing pain and fear of movement were higher in the group with higher DA; body awareness level was lower (p&lt;0.05). A high kinesiophobia level was detected in both groups. <h3>Conclusion</h3> It was observed that high disease activity negatively affected catastrophic thoughts, body awareness, and kinesiophobia in patients with AS. These parameters should be considered in the management of disease activity in AS patients for optimum results. <h3>References</h3> [1]Guenther, V., et al., <i>Body image in patients with ankylosing spondylitis.</i> Clin Exp Rheumatol, 2010. <b>28</b>(3): p. 341-7. [2]Oskay, D., et al., <i>Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis.</i> Turkish journal of medical sciences, 2017. <b>47</b>(5): p. 1340-1347. [3]O'Dwyer, T., F. O'Shea, and F. Wilson, <i>Physical activity in spondyloarthritis: a systematic review.</i> Rheumatology international, 2015. <b>35</b>(3): p. 393-404. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1600-HPR MATERIALS FOR HEALTH PROMOTION ON LIFESTYLE FACTORS FOR PEOPLE WITH RMDS ACROSS EUROPE: ASSESSMENT OF CURRENT MATERIALS AND IMPLEMENTATION NEEDS
Authors: J. Rodríguez-Carrio, G. Cavalli, M. Wieczorek, F. Guillemin, S. Verstappen
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> healthy lifestyle is known to prevent the progression of rheumatic and musculoskeletal diseases (RMDs). Despite contemporary improvements in RMD clinical care, the management of lifestyle factors has received less attention. Underlying causes may be the lack of awareness and insufficient evidence, but patient and physician education may also play a role. <h3>Objectives</h3> to collect and review currently available materials for health promotion on lifestyle factors for people with RMDs across Europe and to assess their implementation needs. <h3>Methods</h3> materials on lifestyle factors (diet, weight control, physical activity, work participation, alcohol consumption and smoking) were collected from health professionals in rheumatology and patient associations through EULAR and EMEUNET channels. <h3>Results</h3> 38 materials from 11 countries were retrieved (Table 1), including North, South, and Central European regions. Documents (22) or leaflets (12) were the most frequent materials. The most reported factor was diet (23) followed by physical activity (17), whereas information on work participation was scarce [2]. The materials were more commonly focused on rheumatoid arthritis (8), although documents for people with RMDs in general were also frequent (12). Only eight materials included scientific references. Although 23 materials contained some kinds of recommendations, only two were evidence-based, whereas the rest contained general statements. Materials were mostly available in the official national language, and 16 were accessible on the internet, whereas no information on accessibility or reach was obtained for the remainder. Significant limitations across implementation domains (process model, determinant frameworks, and evaluation) were observed, mostly due to flawed knowledge generation, poor identification of barriers and facilitators, and lack of evaluation frameworks. <h3>Conclusion</h3> although materials on lifestyle factors were common, they were not always available at the national level across Europe. Current materials are hallmarked by a lack of consistency in formats, layouts, content, focus, lack of scientific evidence and patient involvement. Major impediments for implementation were found. These findings will inform the implementation of EULAR-endorsed recommendations on lifestyle factors for people with RMDs. <h3>Acknowledgements</h3> We thank HPR, PARE associations and EMEUNET for their collaboration in collecting informative materials on lifestyle factors accross European countries. <h3>Disclosure of Interests</h3> None Declared.
AB0261 PREVALENCE OF HEART VALVULAR REGURGITATION ACCORDING TO THE TIME OF DISEASE EVOLUTION IN RHEUMATOID ARTHRITIS PATIENTS
Authors: D. Á. Galarza-Delgado, I. J. Colunga-Pedraza, J. R. Azpiri-López, V. M. Beltran-Aguilar, V. Gonzalez-Gonzalez, A. G. Arias Peralta, N. De Avila Gonzalez, J. A. Cardenas-de la Garza, G. García-Arellano
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) patients are at higher risk of developing cardiovascular (CV) diseases, both ischemic and non-ischemic, than the general population [1]. Inflammatory status and fibrotic changes at cardiac valves in these patients predispose them to a higher risk of valve diseases, which could be detected by echocardiography [2]. <h3>Objectives</h3> To determine the prevalence of valvular regurgitation, according to the time of disease evolution in RA patients. <h3>Methods</h3> Descriptive, comparative, and cross-sectional study. We enrolled RA patients between 40 and 75 years old who fulfilled ACR/EULAR 2010 classification criteria and recruited in the Rheumatology service from tertiary care hospital. Patients were divided by time of disease evolution into quartiles. A transthoracic echocardiogram performed by a certified cardiologist blinded to clinical data. Normality was assesed by Kolmogorov-Smirnov test. Variables with normal and non-normal distribution were described by media and standard deviation, such as median and interquartile range (p25-p75), respectively. Differences between groups was analyzed by ANOVA, Kruskal-Wallis test or Chi-squared, accordingly. <h3>Results</h3> We included 151 RA patients. Demographic characteristics are in Table 1. Overweight/obesity was found between 62-87% of patients, hypertension between 26-34%, and Type 2 Diabetes mellitus between 8-26%. The tricuspid valve was the most affected (73-84%). There was no differences in prevalence of valvular regurgitation. <h3>Conclusion</h3> RA patients have a high prevalence of valvular regurgitation, which could predispose them to develop heart failure, therefore it is important to consider echocardiography in the approach of this population, despite not showing an increase. <h3>References</h3> [1] Crowson CS, Liao KP, Davis JM, Solomon DH, Matteson EL, Knutson KL, et al. Rheumatoid arthritis and cardiovascular disease. Am Heart J. 2013 Oct;166(4):622-628.e1. [2] Maksimowicz-McKinnon K, Mandell BF. Understanding valvular heart disease in patients with systemic autoimmune diseases. Cleve Clin J Med. 2004 Nov 1;71(11):881–5 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1473 ASSESSLE- A NEW TOOL TO ASSESS SLE DISEASE ACTIVITY- THE PATIENTS’ PERSPECTIVE
Authors: D. Paran, M. Ben-Am, L. Mendel, A. Polachek, V. Furer, O. Elalouf, J. Wollman, T. Eviatar, S. Pel, S. Kivity, O. Elkayam, N. Agmon-Levin
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a heterogeneous, waxing, waning, multisystem autoimmune disease. The complexity and clinical unpredictability of SLE challenge the assessment of disease activity over time, especially in everyday clinical practice. Multiple clinical disease- monitoring instruments have been developed, however, they are limited in ability to detect the change in disease activity over time, too cumbersome to be utilized in daily practice, and do not include patient-reported outcomes (PROs). <h3>Objectives</h3> To construct a new disease activity score that will simplify and improve disease activity assessment in daily practice, and include PROs. Here we present the PRO component. <h3>Methods</h3> The new instrument for the assessment of SLE activity is comprised of 7 visual analog scales (VAS), which separately address the physician's global assessment and 6 organ systems. The PRO consists of 5 VAS questions that address general well-being, global disease activity, activities of daily living, medication compliance, and mood. The ASSESSLE PRO is compared to the Short Form Health Survey (SF-36), a 36-item, patient-reported survey of patient health. We applied the ASSESSLE PRO to 46 consecutive patients with SLE attending the rheumatology clinic in 2 tertiary medical centers in Israel. <h3>Results</h3> Psychometric evaluation of the reliability of all 5 PRO questions indicated that question 4, regarding compliance, correlated poorly with the other items and lowered the reliability (Cronbach's α=0.80 95% CI (0.74,0.85). Following the omission of question 4, Cronbach's α was recalculated, leading to increased internal reliability (Cronbach's α = 0.86, 95% CI [0.82, 0.90]). All other remaining items had a satisfactory correlation with the other items ("item-other" correlation between 0.58-0.70). Therefore, the score was computed as the mean of the 4 remaining questions. Aiming to compare the ASSESSLE PRO to the SF-36 survey, the Spearman correlation coefficient between absolute scores was computed and a strong and significant effect was found (R=0.85, p&lt;0.0001). (Figure 1). <h3>Conclusion</h3> The ASSESSLE PRO is a short PRO that allows a reliable, reproducible and simple PRO form showing excellent correlation with the SF-36. Following the omission of question 4, regarding patient compliance, the ASSESSLE PRO consists of only 4 questions, as compared to the SF-36 which requires a response to 36 items. The ASSESSLE PRO seems to have significant advantages due to its intuitive VAS questions and brevity which allows use of this PRO in everyday practice and may increase the validity of disease activity evaluation of SLE when combined with the physician's assessment. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1521 CHARACTERISTICS OF DIFFICULT TO TREAT PSORIATIC ARTHRITIS: A COMPARATIVE ANALYSIS
Authors: C. Philippoteaux, A. Marty-Ane, C. Martin, P. Philippe, J. Paccou, B. Cortet, R. M. Flipo, J. G. Letarouilly
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The concept of difficult-to-treat rheumatoid arthritis (D2T RA) has recently emerged. It is defined by the persistence of disease activity and the failure of at least 2 b/tsDMARDs of 2 different mechanisms of action (MoA) [1]. In this definition, the period of time during which the treatments have failed is not included. The D2T concept has not yet been applied with consensus in psoriatic arthritis (PsA). <h3>Objectives</h3> To study the characteristics of patients with D2T PsA to better identify the potential causes of treatment failure. The 2<sup>nd</sup> objective was to study a sub-group of D2T PsA patients with a predefined time criteria. <h3>Methods</h3> A monocentric retrospective longitudinal study was performed in a tertiary center. PsA diagnosis was based on CASPAR criteria. Patients were followed up from February 2004 to August 2022. Patients starting a b/tsDMARDs with a minimum of 2-year follow-up were included. D2T PsA patients were defined as patients who received more than 2 b/tsDMARDs with different MoA among b/tsDMARD available. These patients were compared to non-D2T PsA patients (nD2T PsA) using statistical tests. Very D2T PsA patients were defined as patients who received at least 2 b/tsDMARDs in less than 2 years during the time of follow-up. <h3>Results</h3> 150 patients were included, 49 were D2T PsA and 101 nD2T PsA. Baseline characteristics are presented in the Table 1. No statistical difference was found between the 2 groups regarding main comorbidities, including fibromyalgia and depression. In the D2T PsA group, 91.7% and 69.1% of patients received an anti-TNF alpha as the 1<sup>st</sup> and 2<sup>nd</sup> lines of treatment; anti-IL17 drugs represented 0% and 12.2% of 1<sup>st</sup> and 2<sup>nd</sup> lines; anti-IL12-23 represented 8% and 18.4% of prescriptions in 1<sup>st</sup> and 2<sup>nd</sup> lines. After 3 lines, 38.8% of patients had received 3 bDMARDs with different MoA, 30.6 % received 2 bDMARDs with different MoA. 17 patients were categorized as very D2T PsA. When compared to the rest of the D2T PsA group, no significant difference was observed. Proportion of men was 64.7% (p=0.39). Mean age was 55.0 ± 8.3 yo (p=0.67) and mean BMI was 30.4 ± 6.5 kg/m<sup>2</sup> (p=0.65). <h3>Conclusion</h3> Significant differences were found between the characteristics of patients D2T PsA and nD2T PsA, which were the presence of axial manifestation, structural damage at baseline and discontinuation due to poor dermatological control. Limitations exist about applying the EULAR D2T RA definition to PsA. The inclusion of a time period should also be considered. <h3>Reference</h3> [1]Nagy G, Roodenrijs NM, Welsing PM, et al. EULAR definition of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis 2021;80:31–5. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1516 CHARACTERISATION OF AN ANA-ARTHRITIS BASKET POPULATION FOR CLINICAL TRIALS
Authors: J. Arnold, L. M. Carter, M. Y. MD Yusof, S. U. Hassan, K. Dutton, Z. Wigston, S. Dass, E. Vital
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Musculoskeletal (MSK) manifestations are common in systemic lupus erythematosus (SLE) and other ANA-associated rheumatic musculoskeletal diseases (ARMDs). Presently clinical trials recruit patients from individual diagnoses; consequently, recruitment is often difficult, effect sizes using multi-organ outcome measures are small and licensed therapies are only available to patients with SLE. Basket trials that pool patients with similar clinical or immunological features from many conventional legacy diagnoses may improve trial outcomes and access to therapy. <h3>Objectives:</h3> 1. To characterise a pooled population of patients with MSK manifestations associated with any of multiple ANA-RMDs 2. To assess the homogeneity of this population in terms of disease activity, patient reported outcomes, quality of life, therapeutics, and immune biomarkers 3. To explore the validity of MSK-BILAG across ANA-RMDs <h3>Methods</h3> Participants were ANA+, met criteria for an ARMD (SLE, pSS, IIM, SSc, MCTD), or had a consultant diagnosis of undifferentiated CTD. Patients with MSK manifestations were identified by MSK items of validated instruments and medical history terms. We collected patient and physician-reported outcomes, SLE gene expression signatures, and flow cytometry for major cell subsets. The pooled ARMD population was compared to healthy controls using t-tests. Variables were compared across ARMDs using ANOVA and χ<sup>2</sup> tests. Physician VAS was compared between MSK-BILAG grades for all diseases. <h3>Results</h3> Of 294 ANA-RMD patients 215 with MSK manifestations were analysed. Key clinical variables are shown in Table 1. We found no difference between ARMDs for IFN, plasmablast, neutrophil, myeloid, inflammation and erythropoiesis scores, nor for naïve, memory B cells, plasmablasts, T cells, monocytes, NK or NKT cells in flow cytometry. Physician VAS was strongly associated with BILAG grade across all ARMDs. <h3>Conclusion</h3> MSK manifestations have similar clinical impact and immune profile across ARMDs. Current therapies used are similar. ANA-arthritis is therefore a homogenous and impactful population for basket trials. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Jack Arnold: None declared, Lucy Marie Carter Consultant of: Consultancy for UCB, Md Yuzaiful Md Yusof Consultant of: Aurinia and UCB, Sabih-Ul Hassan: None declared, Katherine Dutton: None declared, Zoe Wigston: None declared, Shouvik Dass Consultant of: Roche, Abbvie, UCB and Chugai, Edward Vital Speakers bureau: AstraZeneca, Novartis, Paid instructor for: AstraZeneca, Novartis, Consultant of: UCB, Aurinia, Pfizer, Lilly, Roche, Genentech, Otsuka, GSK, Capella.
POS1474 TEMPORAL TRENDS IN JOINT SURGERY FOR LUPUS PATIENTS – A POPULATION BASED LONGITUDINAL STUDY
Authors: J. Nossent, H. Keen, D. Preen, C. Inderjeeth
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Joint damage in SLE results from (peri-) articular inflammation and can present as erosive arthropathy (considered to represent the overlap syndrome Rhupus), deforming Jaccoud's arthropathy or osteonecrosis <sup>[1,2],</sup> in addition to common causes as trauma and degenerative joint disease. <h3>Objectives</h3> We investigated the burden of joint disease requiring orthopaedic procedures (OP) in lupus patients in Western Australia (WA). <h3>Methods</h3> Patients registered in the state-wide Hospital Morbidity Data Collection with a diagnostic code for SLE in the period 1985-2015 (n=2010; 84.7% females, age 42 years (IQR 30-59) were age/gender/index year matched with controls (n=12840, 86% female, age 41 yrs) and procedure codes for arthroplasty, arthrodesis, synovectomy and arthroscopy were extracted. Figures represent median (IQR), frequency (%) and incidence rate (IR) per 100 person years with incidence rate ratios (IRR) to compare IR across groups and over three study decades. <h3>Results</h3> A total of 298 lupus patients (16.1%) underwent 676 OP during 12.3 years follow-up. The IRR for any OP in lupus vs controls was 7.18 (CI 2.5-20.7, p&lt;0.001). In lupus patients, the IR for arthroplasties (1.44, CI 1.26-.56; n=330, 65% hip and knee) and arthrodesis (0.27,CI 0.21-0.34, n= 68) did not change, but IR for synovectomy (n= 58) decreased (0.58 to 0.15) and for arthroscopy (n= 225) increased significantly (0.05 to 1.16). Osteonecrosis affected 32 (1.7%) patients necessitating arthroplasty in 24/32 (75%) while IR for osteonecrosis reduced from 0.19 to 0.11 over time (p=0.12). The proportion of Rhupus patients (with both SLE+RA diagnosis) (11.8%) was stable over time, while OA was a co-diagnosis in 49.1 % of patients undergoing OP vs 2.6 % in patients not requiring OP. Undergoing an OP (with or without arthroscopy) did not impact on long term survival (logrank p =0.16). <h3>Conclusion</h3> There is a high burden of joint damage in lupus patients as one in six patients required an OP at a rate seven times that of controls. These data illustrate that joint symptoms in lupus patients need careful evaluation, including imaging studies <sup>[3]</sup> and comprehensive strategies to reduce long term joint damage. <h3>References</h3> [1]L. Antonini, et al. Rhupus: a systematic literature review. Autoimmunity Reviews 19 (2020) 102612 [2]Kasturi S, Goodman S. Current Perspectives on Arthroplasty in Systemic Lupus Erythematosus: Rates, Outcomes, and Adverse Event. Rheumatol Rep (2016) 18: 59 [3]Smiljanic Tomicevic L, Hocevar A, Sukara G et al.D, Mayer M. The frequency and characteristics of ultrasonographic ankle joint involvement in systemic lupus erythematosus: a prospective cross-sectional single-centre study. Medicine. 2022;101:31(e29196) <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.